Inside Health

Health Care, Step by Step

By DAVID M. HERSZENHORN

Published: January 30, 2010

If Democrats break down their major health care legislation into components that could be approved separately, the first bill up for consideration could be a proposal to end the exemption from federal antitrust laws that insurers have enjoyed since 1945.

The House Judiciary Committee, led by Representative John Conyers Jr., right, Democrat of Michigan, has approved such a bill, and the full House may take action on it early next month, aides to Speaker Nancy Pelosi said Friday.

The Senate Judiciary Committee, led by Senator Patrick J. Leahy, Democrat of Vermont, has approved similar legislation. But it is unclear if the full Senate would support the bill.

The Senate majority leader, Harry Reid of Nevada, supports repealing the antitrust exemption. But there are strong opponents, including Senator Ben Nelson, Democrat of Nebraska, who is a former governor, state insurance commissioner and insurance company executive.

Private insurers strongly oppose a repeal of the antitrust exemption. The House included such a repeal in its comprehensive health care bill; the Senate did not.

House leaders are going through the broader health care bill now to see what other parts they might be able to move forward, even as they continue to work on a way to pass more comprehensive legislation.